Aquatic Therapy for Pediatric Cerebral Palsy Patients

The American Physical Therapy Association (APTA) defines aquatic physical therapy as physical therapy performed in an aquatic environment, not just aquatic exercises. According to the National Institute of Neurological Disorders and Stroke, cerebral palsy is a neurological disorder that occurs in infancy or early childhood. Most children with cerebral palsy have either spastic or floppy muscles, difficulty with motor activities including walking, and/or trouble performing planned movements. Aquatic physical therapy may be used with children who have cerebral palsy.

Benefits

Aquatic physical therapy requires the clinical reasoning and decision-making skills of a physical therapist or physical therapy assistant, while anyone can lead an aquatic exercise program. Aquatic physical therapy is designed to benefit people who have disabilities that can be minimized or eliminated by therapy, which certainly includes children with cerebral palsy. According to United Cerebral Palsy, aquatic physical therapy improves muscle tone and strength while increasing circulation, endurance, flexibility, range of motion, balance and coordination.
Aquatic physical therapy works well for people who have the potential to reach new functional goals or outcomes that will improve their quality of life and/or reduce the burden on caregivers. For example, a child with cerebral palsy can improve her balance, walking, coordination, and agility during aquatic physical therapy sessions. These improvements will allow her to get around more independently and increase her ability to take care of her own activities of daily living such as dressing and bathing. United Cerebral Palsy also says aquatic physical therapy improves psychological well-being and quality of life.

Developing a Treatment Plan

Aquatic physical therapy may focus on treatment, rehabilitation, strengthening, wellness, fitness and/or prevention. When the child is in the water, he benefits from its buoyancy, support and gentle resistance. The therapist will work on individualized, measurable goals designed to improve flexibility, gait, relaxation, balance, coordination and other physical abilities. These goals are developed in collaboration with the child and his family to enhance quality of life.
Treatment plans take into account a transition to land-based activities and coordination with other members of the child's care team. For a very young child with cerebral palsy, the therapist might design goals to increase range of motion of the arms and legs in preparation for sitting and walking later in life. For an older child, aquatic physical therapy goals may center on muscle strengthening and progressive weight-bearing in a water environment where gravity is reduced. Once the child has mastered those goals, she'll be ready for land-based therapy focused on walking.

References

• American Physical Therapy Association
• National Institute of Neurological Disorders and Stroke
• United Cerebral Palsy

Resources

• Disability Resources and Education Services